As screen time becomes the norm, “play” is shifting from outdoor games and sports to sedentary simulations. Despite the large jump in childhood obesity since 2016, particularly in children ages 2 to 5,¹ recess has been reduced in 40% of U.S. school districts.²

Kathleen Tullie, the founder and executive director of Build Our Kids’ Success (BOKS) and senior director of social responsibility of Reebok International, spoke with us about the work she is doing to help children be more active and combat the obesity and mental health epidemic that is plaguing our nation’s youth. Tullie also shared the steps parents, communities and schools can take to get kids more active and, ultimately, bring back play.

The Centers for Disease Control and Prevention recommends 60 minutes of physical activity a day for children. However, due to budget cuts, many schools are eliminating physical education programs. What impact can a lack of physical activity have on a child’s development?

Play and physical activity are fundamental to a child’s well-being – it’s in children’s DNA – and society has taken it out of their lives. We were designed to move, not sit for six to eight hours a day. In fact, physical inactivity is the fourth leading risk factor for global mortality. It’s linked to all the noncommunicable diseases. Physical inactivity is the new smoking, and it’s creating a big issue in not just this country, but worldwide.

The minute you stand up, you begin releasing norepinephrine, dopamine and serotonin and increasing blood flow, which allows you to be more alert. Ten years ago, Dr. Charles Hillman, director of the Neurocognitive Kinesiology Laboratory at Illinois, conducted a study where he put neurotransmitters on two groups of children. One group was walking, and the other was doing a puzzle. He had them take a test, and the scan showed that the children who were walking performed much better.

Dr. John Ratey, a clinical associate professor of psychiatry at Harvard Medical School, has deemed exercise as “Miracle Grow” for the brain. Further evidence is laid out in his book “Spark: The Revolutionary New Science of Exercise and the Brain,” which proves the profound effect that exercise has on the mind. Exercising for between 15 minutes and 20 minutes at 60% to 80% of your maximum heart rate has the same effect as taking Prozac or Ritalin. Meanwhile, we see parents increasingly putting their children on prescription drugs, but the natural drug is out there – let children run around before or during school, and we won’t see this huge increase in children taking prescription drugs. There are cases where children who have ADHD or ADD need to be medicated, but I think we should see if movement could be the prescription that could help.

A lack of physical activity is not only linked to childhood obesity, but mental health issues as well. Teen suicide is up 70% over the past decade. As modern society evolves, children are exposed to more technology and begin to follow what I refer to as “a curated reality.” It’s not an actual reality, but a fear of missing out or upset that their life doesn’t look as good as a curated reality.

Talk about the BOKS program and what you hope children gain from it.

BOKS is a free physical activity program that has grown from one 12-week curriculum focused on functional movements to several different curricula ranging from other fitness-related concepts to mindfulness. A typical curriculum is 12 weeks, consisting of 40- to 45-minute lesson plans three times a week. Not only is the program designed so that anyone (you don’t need a degree or certification in fitness) can bring it to their school, community center or home, but the BOKS team has made sure the lesson plans include a focus on fun.

We know that kids form healthy habits early on, and we do not want them to look at physical activity as a chore, but rather as an enjoyable way to engage with friends and feel good. While each lesson plan emphasizes a particular skill (for example, squats or push-ups), we are intentional about using fun games and relays to practice that skill. We also supply trainers with quick nutrition and mindfulness tips to help target other areas of a child’s well-being.

Between 2018 and 2019, our first BOKS students will have graduated from high school. They are not only overcoming fitness challenges to become stronger physically and mentally, but they are also helping others on their own fitness journeys.

What research have you conducted to support the effectiveness of the BOKS program?

We’ve conducted two different sets of research. We partnered with the National Institute on Out-Of-School Time (NIOST) at Wellesley College. NIOST found that BOKS significantly affected children’s working memory and concluded that participation in the program can contribute to wellness and school success. Recently, we also finished a research study with Harvard Medical School and Massachusetts General Hospital. The results, published in the American Journal of Preventive Medicine, demonstrate that children who participated in BOKS three days a week showed a decrease in BMI and reported feeling deeper social connections to their friends and school and a greater happiness and satisfaction with life.

If you’re a parent and can give your child a magic pill that makes him or her happier, less anxious and less depressed, you would do it every morning. If that’s the case, why aren’t we encouraging our children to run around every morning? We know that it increases cognitive function, confidence and happiness while decreasing depression and anxiety.

How has your connection with Reebok affected your brand?

Without Reebok, we wouldn’t be where we are today. Ten years ago, I came to Reebok for a Friday evening meeting with Matt O’Toole, the president of Reebok, and Uli Becker, former CEO of Reebok. Matt said, “I’ll give you 10 minutes.” Two and a half hours later, we were still talking about the program. He said, “We believe that the sporting goods industry has failed as a whole. We’ve created a culture of spectators. We need to reverse that and create a culture of participants. There’s no better way than to start with the youth.”

BOKS was a perfect fit, and we have proved our impact not only on children, but also parents, communities and schools.

It’s in Reebok’s heritage to help people be their best physically, mentally and socially. It’s an interesting marriage – not many companies have an internal operating nonprofit program like the Reebok Foundation that support programs like BOKS. We are also funded by adidas, Blue Cross Blue Shield, Toyota, CVS and the Boston Foundation. We’re very lucky to have their support.

How did you come up with the idea?

I worked in finance for 20 years, and then I had a cancer diagnosis, so I decided to be a stay-at-home mom. During that time, I came across Dr. Ratey’s book “Spark,” which details the profound impact that exercise has on all of us. I was inspired by the book, so I approached my children’s principal and said, “Can we start a program at our school that addresses the findings in this book?” With the principal and superintendent’s blessing, a small group of parents and I sent out an email to the school community and said, “If you want to drop off your kids an hour before school for fun physical activity, sign up.” We had 80 kids sign up in two weeks.

Were you prepared for that turnout?

No, we were not – but you wing it. You just go with it and put a whistle on your neck and a smile on your face. That’s the beautiful thing about kids: They just want to play. If you give them some balls, they’re going to run around and enjoy it. Through informal parent surveys, we consistently hear that kids find BOKS fun and that they look forward to going to school on BOKS days.

Within a couple weeks, parents and teachers were telling me about the positive difference they were seeing in their children. Their children wanted to go to school, and they were sleeping better at night.

Do you have a concentration in any part of the United States?

We have a concentration where we have our headquarters or where we have a local person on the ground – Boston, Washington, D.C., New York City, Rhode Island and Denver. We’ve seen some markets grow organically. Atlanta is one, and the West Coast seems to be the next frontier. Internationally, we’ve reached Canada and Japan.

How much does it cost a school to run a BOKS program?

The program and the training are free. The only thing that we need funding for is the operating cost of running it in 4,000 schools and the marketing tools. In low-income areas, if we can’t find parent volunteers, we pay a stipend to pay a couple of trainers to run the program. We also partner with the Boys & Girls Club and YMCA to ensure that they have our tools.

What about nutrition? What’s the connection between physical activity, nutrition and development?

In the U.S., we have 6 million morbidly obese children. I am a member of the Roundtable for Obesity Solutions for the National Academy of Sciences, and what we allow to be marketed to our children is appalling. We’ve evolved into a culture of convenience, and everybody is trying to find a quick thing to eat. Healthy food is often expensive and not accessible.

It’s important to get physical activity and good nutrition into a child’s life early, and the beautiful thing about BOKS is that nutritional education is part of it. We partnered with Tufts Medical Center to offer nutrition tips. We ask children, “How many sugar cubes are in a sports drink?” It’s been hugely impactful. Parents stop me on the soccer field and say, “What did you do to my child? Now when I go to the store, they’re telling me how to read labels and to only shop on the perimeter of the grocery store.”

It’s like the seatbelt campaign or the smoking campaign. It’s the children educating the adults. We’re old dogs. We’re not going to be taught new tricks, but when our children come to us and say, “Mom, I really want to eat healthy,” we listen.

What’s your vision for the future of BOKS?

My hope for BOKS is that the name extends well beyond a series of curricula and that BOKS becomes known as a resource for evidence-based research validating the importance of physical activity on the overall well-being of a child. Beyond that, I hope that we help impact education policy so that physical activity becomes a visible, regular part of every child’s school day. To do that, I feel it is important that BOKS partners with many companies across sectors like banking, technology and pharmaceuticals. It is our hope that these industries will recognize the role they can play in making children’s overall well-being a priority.

Can you talk about the moment you realized that your vision would be a success?

I feel the success of the program every time a stranger outside of my community approaches me to start a conversation about the value of BOKS and the positive effect the program had on their child. Those moments have solidified my belief that we can empower people everywhere to help combat the lack of physical inactivity in schools. However, true success will happen when our education system recognizes and raises the priority of physical activity in academic programming.